von Aurora Dollenberg ; Sebastian Moeller ; Caroline Lücke ; Ruihao Wang ; Alexandra Philomena Lam ; Alexandra Philipsen ; Jürgen M. Gschossmann ; Falk Hoffmann ; Helge H. O. Müller
von Caroline Lücke ; Jürgen M. Gschossmann ; Teja Wolfgang Grömer ; Sebastian Möller ; Charlotte E. Schneider ; Aikaterini Zikidi ; Alexandra Philipsen ; Helge H. O. Müller
Objective: The hospitalization of patients for medical reasons potentially generates enormous psychological stress and may evoke psychiatric pathology of the affective/anxiety-spectrum. It is well known that affective disorders are very common diagnoses among somatically ill patients. Here, we further investigated the characteristics of depression and anxiety in hospital patients by studying data from a large sample of psychiatric consultations of medical inpatients. Methods: In a prospective, observational design we collected and analyzed data from 890 psychiatric consultations of somatically ill hospital patients, who required psychiatric assessment by consultation-liaison services due to acute psychopathology. Only data that were collected as part of the routine psychiatric care were processed for this study. Patients were seen in two German hospitals, Klinikum Forchheim and University Clinic Erlangen. More than 90% of consultations were carried out by the same three psychiatrists. Results: Affective disorders were the most common diagnoses given to patients as a result of the consultation (39.2%). A further 10.4% of patients suffered from reaction to severe stress and adjustment disorders and 7.7% suffered from anxiety disorders. More than 80% of patients with disorders of the affective/anxiety spectrum required further treatment following the consultation, and 36.1% of patients with affective disorders required inpatient psychiatric treatment. Relatively few patients had received regular psychiatric treatment or psychotherapy prior to the hospital stay (24.8% for affective disorders, 19.1% for anxiety disorders and 9.2% for reaction to severe stress and adjustment disorders), yet 82.5% of patients had a pre-existing psychiatric diagnosis. Conclusion: Our findings underline the potential of a medical hospital stay to trigger substantial psychiatric symptoms in patients with and without a pre-known psychiatric diagnosis. Patients with a pre-existing diagnosis of affective or anxiety disorders seem to be at particular risk of developing psychopathology in the course of a somatic hospital stay. Better routine psychiatric care is needed to prevent the development or exacerbation of psychopathology in hospital patients.
Journal of depression & anxiety Los Angeles, CA : OMICS Publ. Group, 2012 Bd. 6.2017, 3, Art.-Nr. 1000276, insges. 5 S. Online-Ressource
von Helge H. O. Müller ; Mareen Reike ; Simon Grosse-Holz ; Mareike Röther ; Caroline Lücke ; Alexandra Philipsen ; Johannes Kornhuber ; Teja Wolfgang Grömer
Cognitive behavioral therapy (CBT) is the standard form of psychotherapy currently used in adult attention deficit hyperactivity disorder (ADHD). However, biographical factors, such as chronic negative feedback in childhood, which may likely play a role in ADHD as a developmental disorder, are usually not substantially addressed by CBT. In recent years, schema therapy has received increasing attention as an effective therapy approach for chronic psychiatric disorders. A core feature of schema therapy is the identification and targeting of early maladaptive schemas, which are dysfunctional patterns and beliefs resulting from childhood experiences. Recently, two studies have demonstrated an increased prevalence of maladaptive schemas in adult ADHD. Thus, schema therapy might constitute a potentially promising approach in the treatment of ADHD, especially with regard to secondary problems such as poor coping strategies or impaired self-perception. However, randomized controlled clinical studies are needed to support that theory. Here, we provide an overview on the topic of biography-oriented therapy approaches in relation to adult ADHD, summarize current literature and discuss implications for future research.
Journal of neurology & neuromedicine Grand Rapids, MI : Sciaccess Publishers, LLC, 2016 2(2017), 7, Seite 6-10 Online-Ressource
von Caroline Lücke ; Jürgen M. Gschossmann ; Alena Schmidt ; Alexandra Philomena Lam ; Charlotte Elisabeth Schneider ; Alexandra Philipsen ; Helge H. Müller
Background Psychiatric comorbidities are common in somatically ill patients. There is a lack of data that can provide clear insights into substantial comparative advantages of different Consultation/Liaison Psychiatry (CLP) services. Methods The Consultation versus Liaison Psychiatry-Study collected and analyzed data of 890 primarily somatically ill hospital inpatients presenting with psychiatric symptoms in a prospective observational study design. One group was treated via a liaison-model (LM) with regular consultation hours, the other via an on-demand-model (ODM) with individually requested consultations. Results Five hundred forty-five LM and 345 ODM patients were compared. Patients in the LM were, on average, older compared to the patients of the ODM. The vast majority (90.8%) of individuals for whom a psychiatric consultation was requested came from internal medicine. The most common diagnoses were affective disorders (39.3%), organic mental disorders (18.9%), alcohol-induced mental disorders (11.3%) and reactions to severe stress/adjustment disorders (10.4%). Organic mental disorders were significantly more common in patients seen in the LM (24.0% vs. 10.3%, p < 0.001) while affective disorders were more frequently diagnosed in the ODM (46.6% vs. 34.8%, p = 0.001). Patients seen in the ODM were, on average, more severely affected compared to patients seen in the LM and required more extensive treatment. 16.3% of ODM patients were regarded as potentially suicidal; among these, 3.5% were acutely suicidal and 12.8% latently suicidal. Any form of further treatment was required by 93.0% of ODM patients compared to 77.8% in the LM. Pharmacological treatment with benzodiazepines, usually used as short-term treatment, was more frequently prescribed to patients seen in the ODM while patients seen in the LM were more often started on selective serotonin reuptake inhibitors, indicative of long-term treatment. Conclusions Patients in need of less acute treatment were considerably less common in the ODM. The data indicate a possible risk of such patients to remain unrecognized. A quasi-liaison model is recommended to be the best suitable and cost-effective way of providing psychiatric care to somatically ill patients with psychiatric comorbidities.
BMC psychiatry London : BioMed Central, 2001 Bd. 17 (2017), 1, 10. (Jan.), insges. 8 S. Online-Ressource
Our aim was to summarize the current relevant literature on concomitant psychiatric symptoms with a focus on anxiety/depression in a population with gynecologic cancer; to identify the predictors, associated factors, and prevention strategies of psychiatric disorders; to examine psychiatric disorders in a population with recurrent gynecologic cancer; and to describe the limitations of the literature and future research areas. Little is known about attending psychiatric disorders in patients with gynecologic and other malignant diseases like cervical or breast cancer. However, patients suffering from other types of gynecologic cancer (eg, genital/cervical cancer) may also have an increased risk of psychiatric symptoms. In this review, we identify the potential information deficits in this field. A two-rater independent literature search was conducted using the PubMed/Google Scholar search engines to systematically evaluate the literature on the research objectives, followed by a critical reflection on the results. Of the 77 screened studies, 15 met the criteria for inclusion in this review. Patients with gynecologic malignancies, especially cervical cancer, had a very high prevalence of psychiatric symptoms including depression (33%–52%). Additionally, the risk groups facing higher rates of concomitant reduced quality of life and increased psychiatric symptoms such as depression were identified. Specifically, low socioeconomic status, sexual inactivity, absence of a partner, and physical symptoms were correlated with an increased risk. Patients suffering from recurrent gynecologic cancer should receive particular attention because of their significantly increased risk of depressive symptoms. Screening programs are needed to detect psychiatric symptoms in cervical cancer patients and the associated high-risk groups. Regular screening should be implemented, and psychosocial care should be provided during follow-up.
International journal of women's health Macclesfield [u.a.] : Dove Medical Press, 2009 9(2017), Seite 795-805 Online-Ressource
von Stella Welter ; Caroline Lücke ; Alexandra Philomena Lam ; Christina Custal ; Sebastian Möller ; Peter Sörös ; Christiane M. Thiel ; Alexandra Philipsen ; Helge H. O. Müller
von Sebastian Möller ; Neele Kalkwarf ; Caroline Lücke ; Diana Ortiz Gonzalez ; Sonja Jahn ; Christiane Först ; Niclas Braun ; Alexandra Philipsen ; Helge H. O. Müller
